Nonbacterial thrombotic endocarditis with recurrent embolic events as manifestation of ovarian neoplasm

Arash Aryana, Dennis J. Esterbrooks, Peter C. Morris

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

We describe the case of a 43-year-old woman with transient ischemic neurologic deficits and recurrent systemic and pulmonary emboli in whom infectious work-up and extensive thrombophilic evaluation were unremarkable. Transesophageal echocardiography (TEE) established the diagnosis of nonbacterial thrombotic endocarditis (NBTE). This is a rare condition often associated with hypercoagulable states or advanced malignancy such as adenocarcinomas, characterized by cardiac vegetations along valvular coaptation lines without destruction of leaflets. In our patient, we diagnosed an ovarian clear cell adenocarcinoma, a malignant disorder that has been rarely reported in association with NBTE. This case illustrates that NBTE can present as an atypical manifestation of malignancy and must be distinguished from infective endocarditis, which implies a different therapeutic strategy. When confronted with findings of NBTE without a clear etiology, an occult neoplasm must be excluded. Anticoagulant therapy is the mainstay of treatment. However, cardiac vegetations may require surgical intervention in rare instances.

Original languageEnglish
JournalJournal of General Internal Medicine
Volume21
Issue number12
DOIs
StatePublished - Dec 2006

Fingerprint

Endocarditis
Ovarian Neoplasms
Clear Cell Adenocarcinoma
Neoplasms
Transesophageal Echocardiography
Neurologic Manifestations
Embolism
Anticoagulants
Adenocarcinoma
Therapeutics
Lung

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Nonbacterial thrombotic endocarditis with recurrent embolic events as manifestation of ovarian neoplasm. / Aryana, Arash; Esterbrooks, Dennis J.; Morris, Peter C.

In: Journal of General Internal Medicine, Vol. 21, No. 12, 12.2006.

Research output: Contribution to journalArticle

@article{e4d062d9bcf74bc8b4855bcba950ef8d,
title = "Nonbacterial thrombotic endocarditis with recurrent embolic events as manifestation of ovarian neoplasm",
abstract = "We describe the case of a 43-year-old woman with transient ischemic neurologic deficits and recurrent systemic and pulmonary emboli in whom infectious work-up and extensive thrombophilic evaluation were unremarkable. Transesophageal echocardiography (TEE) established the diagnosis of nonbacterial thrombotic endocarditis (NBTE). This is a rare condition often associated with hypercoagulable states or advanced malignancy such as adenocarcinomas, characterized by cardiac vegetations along valvular coaptation lines without destruction of leaflets. In our patient, we diagnosed an ovarian clear cell adenocarcinoma, a malignant disorder that has been rarely reported in association with NBTE. This case illustrates that NBTE can present as an atypical manifestation of malignancy and must be distinguished from infective endocarditis, which implies a different therapeutic strategy. When confronted with findings of NBTE without a clear etiology, an occult neoplasm must be excluded. Anticoagulant therapy is the mainstay of treatment. However, cardiac vegetations may require surgical intervention in rare instances.",
author = "Arash Aryana and Esterbrooks, {Dennis J.} and Morris, {Peter C.}",
year = "2006",
month = "12",
doi = "10.1111/j.1525-1497.2006.00614.x",
language = "English",
volume = "21",
journal = "Journal of General Internal Medicine",
issn = "0884-8734",
publisher = "Springer New York",
number = "12",

}

TY - JOUR

T1 - Nonbacterial thrombotic endocarditis with recurrent embolic events as manifestation of ovarian neoplasm

AU - Aryana, Arash

AU - Esterbrooks, Dennis J.

AU - Morris, Peter C.

PY - 2006/12

Y1 - 2006/12

N2 - We describe the case of a 43-year-old woman with transient ischemic neurologic deficits and recurrent systemic and pulmonary emboli in whom infectious work-up and extensive thrombophilic evaluation were unremarkable. Transesophageal echocardiography (TEE) established the diagnosis of nonbacterial thrombotic endocarditis (NBTE). This is a rare condition often associated with hypercoagulable states or advanced malignancy such as adenocarcinomas, characterized by cardiac vegetations along valvular coaptation lines without destruction of leaflets. In our patient, we diagnosed an ovarian clear cell adenocarcinoma, a malignant disorder that has been rarely reported in association with NBTE. This case illustrates that NBTE can present as an atypical manifestation of malignancy and must be distinguished from infective endocarditis, which implies a different therapeutic strategy. When confronted with findings of NBTE without a clear etiology, an occult neoplasm must be excluded. Anticoagulant therapy is the mainstay of treatment. However, cardiac vegetations may require surgical intervention in rare instances.

AB - We describe the case of a 43-year-old woman with transient ischemic neurologic deficits and recurrent systemic and pulmonary emboli in whom infectious work-up and extensive thrombophilic evaluation were unremarkable. Transesophageal echocardiography (TEE) established the diagnosis of nonbacterial thrombotic endocarditis (NBTE). This is a rare condition often associated with hypercoagulable states or advanced malignancy such as adenocarcinomas, characterized by cardiac vegetations along valvular coaptation lines without destruction of leaflets. In our patient, we diagnosed an ovarian clear cell adenocarcinoma, a malignant disorder that has been rarely reported in association with NBTE. This case illustrates that NBTE can present as an atypical manifestation of malignancy and must be distinguished from infective endocarditis, which implies a different therapeutic strategy. When confronted with findings of NBTE without a clear etiology, an occult neoplasm must be excluded. Anticoagulant therapy is the mainstay of treatment. However, cardiac vegetations may require surgical intervention in rare instances.

UR - http://www.scopus.com/inward/record.url?scp=33750495166&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750495166&partnerID=8YFLogxK

U2 - 10.1111/j.1525-1497.2006.00614.x

DO - 10.1111/j.1525-1497.2006.00614.x

M3 - Article

VL - 21

JO - Journal of General Internal Medicine

JF - Journal of General Internal Medicine

SN - 0884-8734

IS - 12

ER -